Heyworth L, Kirsh S, Zulman D, Ferguson JM, Kizer KW. Expanding access through virtual care: The VA’s early experience with Covid-19. N Engl J Med. 2020;1(4)

Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457-502. https://doi.org/10.1111/j.1468-0009.2005.00409.x

Article  PubMed  PubMed Central  Google Scholar 

Fortney JC, Steffick DE, Burgess JF, Jr., Maciejewski ML, Petersen LA. Are primary care services a substitute or complement for specialty and inpatient services? Health Serv Res. 2005;40(5 Pt 1):1422-42. https://doi.org/10.1111/j.1475-6773.2005.00424.x

Article  PubMed  PubMed Central  Google Scholar 

Ohl ME, Richardson K, Kaboli PJ, Perencevich EN, Vaughan-Sarrazin M. Geographic access and use of infectious diseases specialty and general primary care services by veterans with HIV infection: implications for telehealth and shared care programs. J Rural Health. 2014;30(4):412-21. https://doi.org/10.1111/jrh.12070

Article  Google Scholar 

Malayala SV, Vasireddy D, Atluri P, Alur RS. Primary Care Shortage in Medically Underserved and Health Provider Shortage Areas: Lessons from Delaware, USA. J Prim Care Community Health. 2021;12:2150132721994018-2150132721994018. https://doi.org/10.1177/2150132721994018

Article  PubMed  PubMed Central  Google Scholar 

Bodenheimer TS, Smith MD. Primary Care: Proposed Solutions To The Physician Shortage Without Training More Physicians. Health Affairs. 2013;32(11):1881-1886. https://doi.org/10.1377/hlthaff.2013.0234

Article  PubMed  Google Scholar 

Moldestad M, Sayre G, Rinne S, et al. Perspectives on training and working in the VHA: Implications for primary care physician recruitment and retention. Acad Med. 2022;97(8):1175-1183.

Article  PubMed  Google Scholar 

MacArthur KR, Royer E, Hawkins DN. Addressing the Enduring Primary Care Physician Shortage in The United States: The Direct and Indirect Effects of Gender on the Medical Specialty Decision-Making Process. Int J Med Stud. 2018;6(3):91-97. https://doi.org/10.5195/ijms.2018.296

Article  Google Scholar 

Johnson V, Wong E, Lampman M, et al. Comparing Patient-Centered Medical Home Implementation in Urban and Rural VHA Clinics: Results From the Patient Aligned Care Team Initiative. J Ambul Care Manage. 2018;41(1):47-57. https://doi.org/10.1097/JAC.0000000000000212

Article  PubMed  Google Scholar 

Weeks WB, Yano EM, Rubenstein LV. Primary Care Practice Management in Rural and Urban Veterans Health Administration Settings. J Rural Health. 2002;18(2):298-303. https://doi.org/10.1111/j.1748-0361.2002.tb00890.x

Article  PubMed  Google Scholar 

Wallace AE, Lee R, MacKenzie TA, et al. A Longitudinal Analysis of Rural and Urban Veterans’ Health-Related Quality of Life. J Rural Health. 2010;26(2):156-163. https://doi.org/10.1111/j.1748-0361.2010.00277.x

Article  PubMed  Google Scholar 

Weeks WB, Wallace AE. Rural–Urban Differences in Primary Care Physicians’ Practice Patterns, Characteristics, and Incomes. J Rural Health. 2008;24(2):161-170. https://doi.org/10.1111/j.1748-0361.2008.00153.x

Article  PubMed  Google Scholar 

West A, Weeks WB. Physical and Mental Health and Access to Care Among Nonmetropolitan Veterans Health Administration Patients Younger Than 65 Years. J Rural Health. 2006;22(1):9-16. https://doi.org/10.1111/j.1748-0361.2006.00014.x

Article  PubMed  Google Scholar 

Hardman B, Newcomb P. Barriers to Primary Care Hospital Follow-up Among Older Adults in Rural or Semi-rural Communities. Appl Nurs Res. 2016;29:222-228. https://doi.org/10.1016/j.apnr.2015.05.003

Article  PubMed  Google Scholar 

Zhang D, Son H, Shen Y, et al. Assessment of Changes in Rural and Urban Primary Care Workforce in the United States From 2009 to 2017. JAMA Netw Open. 2020;3(10):e2022914-e2022914. https://doi.org/10.1001/jamanetworkopen.2020.22914

Article  PubMed  PubMed Central  Google Scholar 

Burnett K, Stockdale SE, Yoon J, et al. The Clinical Resource Hub Initiative: First-Year Implementation of the Veterans Health Administration Regional Telehealth Contingency Staffing Program. J Ambul Care Manage. 2023;https://doi.org/10.1097/jac.0000000000000468

Stockdale S, Rose D, Bonilla A, et al. Early implementation progress of VHA’s national clinical resource hub initiative. presented at: Academy Health; June 15, 2021

Rubenstein LV, Curtis I, Wheat CL, et al. Learning from National Implementation of the Veterans Affairs Clinical Resource Hub (CRH) Program for Improving Access to Care: Protocol for a Six Year Evaluation. BMC Health Serv Res. 2023;23(1):790. https://doi.org/10.1186/s12913-023-09799-5

von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. J Clin Epidemiol. 2008;61(4):344-9. https://doi.org/10.1016/j.jclinepi.2007.11.008

Article  Google Scholar 

University of Wisconsin School of Medicine and Public Health. 2015 Area Deprivation Index v2.0. Accessed February 4, 2021, https://www.neighborhoodatlas.medicine.wisc.edu/

VHA Directive 1229 (1) - Planning and Operating Outpatient Sites of Care (2019).

Gupta D, Potthoff S, Blowers D, Corlett J. Performance Metrics for Advanced Access. J Healthc Manag. 2006;51(4):246-258. https://doi.org/10.1097/00115514-200607000-00007

Article  PubMed  Google Scholar 

Hempel S, Hilton LG, Stockdale S, et al. Defining access management in health care delivery organizations. J Ambulat Care Manage. 2021;44(3):218-226.

Article  PubMed  Google Scholar 

Risk Adjustment: Guide to the V21 and Nosos Risk Score Programs: Technical Report 30 (2016).

University of Washington Rural Health Research Center and USDA Economic Research Service (ERS). Rural-Urban Commuting Area Codes. Accessed December 13, 2018, http://depts.washington.edu/uwruca/ruca-uses.php

Ho DE, Imai K, King G, Stuart EA. MatchIt: Nonparametric Preprocessing for Parametric Causal Inference. J Stat Softw. 2011;42(8):1-28. https://doi.org/10.18637/jss.v042.i08

Article  Google Scholar 

Bates D, Mächler M, Bolker BM, Walker SC. Fitting Linear Mixed-effects Models Using lme4. J Stat Softw. 2015;67(1):1-48. https://doi.org/10.18637/jss.v067.i01

Article  Google Scholar 

Maani N, Galea S. The Role of Physicians in Addressing Social Determinants of Health. JAMA. 2020;323(16):1551-1552. https://doi.org/10.1001/jama.2020.1637

Article  PubMed  Google Scholar 

Lindsay JA, Caloudas A, Hogan J, et al. Getting Connected: a Retrospective Cohort Investigation of Video-to-Home Telehealth for Mental Health Care Utilization Among Women Veterans. J Gen Intern Med. 30 2022:1-8. https://doi.org/10.1007/s11606-022-07594-2

Ladino MA, Wiley J, Schulman IH, et al. Tele-Nephrology: A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas. Telemed e-Health. 2016;22(8):65-654. https://doi.org/10.1089/tmj.2015.0197

Article  Google Scholar 

Wilkinson J, Myers L, Daggy J, et al. The VA National Teleneurology Program (NTNP): Implementing Teleneurology to Improve Equitable Access to Outpatient Neurology Care. J Gen Intern Med. 2023;38(Suppl 3):887-893. https://doi.org/10.1007/s11606-023-08121-7

Article  PubMed  PubMed Central  Google Scholar 

O'Shea AMJ, Howren MB, Mulligan K, Haraldsson B, Shahnazi A, Kaboli PJ. Quantifying the Digital Divide: Associations of Broadband Internet with Tele-mental Health Access Before and During the COVID-19 Pandemic. J Gen Intern Med. 2023;38(Suppl 3):832-840. https://doi.org/10.1007/s11606-023-08120-8

Article  PubMed  PubMed Central  Google Scholar 

Chang JE, Lindenfeld Z, Albert SL, et al. Telephone vs. Video Visits During COVID-19: Safety-Net Provider Perspectives. J Am Board Fam Med. 2021;34(6):1103-1114. https://doi.org/10.3122/jabfm.2021.06.210186

O'Shea AMJ, Gibson M, Merchant J, et al. Understanding Rural-urban Differences in Veterans’ Internet Access, use and Patient Preferences for Telemedicine. J Rural Health. 2023;n/a(n/a)https://doi.org/10.1111/jrh.12805

Weigel PAM, Ullrich F, Shane DM, Mueller KJ. Variation in primary care service patterns by rural-urban location. J Rural Health. 2016;32(2):196-203.

Article  PubMed  Google Scholar 

Rabinowitz HK, Diamond JJ, Markham FW, Hazelwood CE. A Program to Increase the Number of Family Physicians in Rural and Underserved Areas: Impact After 22 Years. Jama. 20 1999;281(3):255-60. https://doi.org/10.1001/jama.281.3.255

Article  CAS  PubMed  Google Scholar 

O'Shea AMJ, Baum A, Haraldsson B, et al. Association of adequacy of broadband internet service with access to primary care in the veterans health administration before and during the COVID-19 Pandemic. JAMA Netw Open. 2022;5(10):e2236524-e2236524.

Article  PubMed  PubMed Central  Google Scholar 

Zahnd WE, Bell N, Larson AE. Geographic, Racial/ethnic, and sOcioeconomic Inequities in Broadband Access. J Rural Health. 2022;38(3):519-526. https://doi.org/10.1111/jrh.12635

Article  PubMed  Google Scholar 

Ekezue BF, Bushelle-Edghill J, Dong S, Taylor YJ. The effect of Broadband Access on Electronic Patient Engagement Activities: Assessment of Urban-rural Differences. J Rural Health. 2022;38(3):472-481. https://doi.org/10.1111/jrh.12598

Article  PubMed  Google Scholar 

Affairs USDoV. Digital Divide Standard Operating Procedure. Veterans Health Administration, Office of Connected Care.

U.S. Department of Veteran Affairs. Bridging the Digital Divide. Access